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Which Lipids Should Be Analyzed for Diagnostic Workup and Follow-up of Patients with Hyperlipidemias?

  • Lipid Abnormalities and Cardiovascular Prevention (G De Backer, Section Editor)
  • Published:
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Abstract

Purpose of Review

To summarize and discuss the clinical use of lipid and apolipoprotein tests in the settings of diagnosis and therapeutic follow-up of hyperlipidemia.

Recent Findings

The joint consensus panel of the European Atherosclerosis Society (EAS) and the European Federation of Clinical Chemistry and Laboratory Medicine (EFLM) recently produced recommendations on the measurement of atherogenic lipoproteins, taking into account the strengths and weaknesses of analytical and clinical performances of the tests.

Summary

Total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, and calculated non-HDL cholesterol (= LDL + remnant cholesterol) constitute the primary lipid panel for hyperlipidemia diagnosis and cardiovascular risk estimation. LDL cholesterol is the primary target of lipid-lowering therapies. Non-HDL cholesterol or apolipoprotein B should be used as secondary therapeutic target in patients with mild-to-moderate hypertriglyceridemia, 2–10 mmol/l (175–880 mg/dl). Lipoprotein (a) is included in LDL cholesterol and should be measured at least once in all patients at cardiovascular risk, including to explain poor response to statin treatment.

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Abbreviations

apoA-I:

Apolipoprotein A-I

apoB:

Apolipoprotein B

CETP:

Cholesteryl ester transfer protein

CHD:

Coronary heart disease

CVD:

Cardiovascular disease

FCH:

Familial combined hyperlipidemia

FH:

Familial hypercholesterolemia

HDL (C):

High-density lipoprotein (cholesterol)

HL:

Hepatic lipase

IDL:

Intermediate-density lipoprotein

KIV-2:

Kringle IV type 2

LCAT:

Lecitin:cholesterol acyltransferase

LDL (C):

Low-density lipoprotein (cholesterol)

cLDLC:

Calculated LDL cholesterol

Lp (a):

Lipoprotein (a)

LPL:

Lipoprotein lipase

NMR:

Nuclear magnetic resonance

PCSK9:

Proprotein convertase subtilisin/kexin type 9

Remnant-C:

Remnant lipoprotein cholesterol

SCORE:

Systematic coronary risk evaluation

TC:

Total cholesterol

TG:

Triglycerides

VLDL (C):

Very low-density lipoprotein (cholesterol)

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Authors and Affiliations

  1. AZ St.-Jan Hospital, Department of Laboratory Medicine, Ruddershove 10, 8000, Brugge, Belgium

    Michel R. Langlois

  2. University of Ghent, Ghent, Belgium

    Michel R. Langlois

  3. Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark

    Børge G. Nordestgaard

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  1. Michel R. Langlois
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Correspondence to Michel R. Langlois.

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Michel R. Langlois reports an educational grant from Roche Diagnostics and speaker honorarium from Amgen.

Børge G. Nordestgaard reports being the Danish tax payer for education, wages and research funding; and consultancies or talks sponsored by AstraZeneca, Sanofi, Regeneron, Ionis, Akcea, Amgen, Kowa, Denka Seiken.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Lipid Abnormalities and Cardiovascular Prevention

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Langlois, M.R., Nordestgaard, B.G. Which Lipids Should Be Analyzed for Diagnostic Workup and Follow-up of Patients with Hyperlipidemias?. Curr Cardiol Rep 20, 88 (2018). https://doi.org/10.1007/s11886-018-1036-1

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